Analysis of cases of dermatological referrals and their systemic correlation in a tertiary care hospital in Gangtok: a prospective study

Abstract

<p class="abstract"><strong>Background:</strong> Practice of dermatology in a teaching hospital is not merely limited to inpatient and out patients’ management but also boost up the clinical knowledge of young medical graduates and medical students. Many dermatological diseases might be directly or indirectly associated or related with the primary diseases for which the patient is admitted in the hospital or it may also be the dermatological manifestation of systemic diseases.</p><p class="abstract"><strong>Methods:</strong> The aim of the study was to analyze the type of dermatological diseases referred from the indoor patients of various departments and to identify its relation to systemic diseases. Consecutive sampling was applied on 297 referrals of indoor patients from various other specialties with dermatological disease.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 297 referrals majority, 145 were from the department of medicine and only one, the least number, from Gastroenterology. Maximum number of cases that encountered was the viral infection with 39 cases. 128 patients had dermatological manifestations of primary diseases or directly or indirectly related to it and the rest 169 fell in unrelated group.</p><p class="abstract"><strong>Conclusions:</strong> Dermatological referrals from other specialties was noted to be an eye opener to the no dermatologist and beneficial to the patients in terms of providing proper guidance and evidence based treatment avoiding unnecessary investigations. This also emphasizes the need for a proper training of young non dermatologists.</p>

Pattern of dermatology referrals in a tertiary care center in North East India

“…Among dermatological diagnosis, infections were the most common followed by eczema which was similar to other studies. 3,4,[10][11][12][13]17,[19][20][21][22][24][25][26] Viral infections were most common than fungal infections which was similar to the study by Sharma et al 19 Immunosuppression in admitted patients may be the reason for infections. Study by Fischer et al had candidiasis as the most common infection overall where as in present study it was the second common fungal infection next to dermatophyte.…”

“…This is in accordance with most of the available literature. 3,4,7,8,10,[12][13][14][15][16][17][18][19][20][21][22] Many medical disorders are associated with dermatological manifestations which serve as important clues for diagnosis of the underlying medical conditions. Other reasons include increased patient admissions in medicine, longer hospital stay, multiple diseases and polypharmacy thereby increasing the risk of adverse drug reaction and concurrent infections.…”

The Role of Ferritin Serum Level as Predictor Sepsis Mortality on Children in Dr. Moewardi Hospital of Surakarta

“…The ROC curve in our study had AUC value of 0.760 with the serum ferritin cutoff point for predicting mortality in sepsis patients of 975 ng/ml which a sensitivity of 87.5 %, specificity of 75 %, and p value of 0.006. Meanwhile Sharma et al study in childre with sepsis reported that elevated ferritin levels of > 1000 ng/L had a sensitivity of 58.9% and a specificity of 75.3% as a predictor of death with a relative risk of 2.38 (95% CI: 1.57-3.61) and an odds ratio of 4.36 ( 95% CI: 2.14 -8.88) while the AUC value was 0.68 (Sharma et al, 2018).…”

“…In contrast to bacterial infection, it is usually associated with extensive over expression of IL-1β effecting an IL-6 to trigger hepatocytic CRP, which acts as an initial host defense by promoting bacterial phagocytosis. In addition, increased ferritin in sepsis can occur as a consequence blockade of iron release due to virulence factors induced by microorganisms in the acute phase (Sharma et al, 2018;Chiou et al, 2018;slats et al, 2016).…”

“…In the last decade it was known that C-reactive and procalcitonin are good markers of infection and routinely examined in patients, but they are less specific to differentiate between viruses and bacteria infection. There are several new markers that are interesting to study, one of which is ferritin (Sharma et al, 2018).…”